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1.
Rev. Col. Bras. Cir ; 49: e20213152, 2022. tab, graf
Article in English | LILACS | ID: biblio-1365380

ABSTRACT

ABSTRACT Introduction: the botulinum toxin A (BTA) has been used to achieve a chemical component separation, and it has been used with favorable outcomes for the repair of complex ventral hernia (CVH) with and without loss of domain (LD). The aim of this study is to describe our early experience with the chemical component separation in the United Sates. Methods: a retrospective observational study of all patients who underwent ventral hernia repair for CVH with or without LD between July 2018 and June 2020. Preoperative BTA was injected in all patients via sonographic guidance bilaterally, between the lateral muscles to achieve chemical denervation before the operation. Patient demographics, anatomical location of the hernia, perioperative data and postoperative data are described. Results: 36 patients underwent this technique before their hernia repair between July 2018 to June 2020. Median age was 62 years (range 30-87). Median preoperative defect size was 12cm (range 6-25) and median intraoperative defect size was 13cm (range 5-27). Median preoperative hernia sac volume (HSV) was 1338cc (128-14040), median preoperative abdominal cavity volume (ACV) was 8784cc (5197-18289) and median volume ration (HSV/ACV) was 14%. The median OR time for BTA administration was 45 minutes (range 28-495). Seroma was the most common postoperative complication in 8 of the patients (22%). Median follow up was 43 days (range 0-580). Conclusion: preoperative chemical component separation with BTA is a safe and effective adjunct to hernia repair in CVH repairs where a challenging midline fascial approximation is anticipated.


RESUMO Introdução: a toxina botulínica A (TBA) tem sido usada para alcançar a separação química dos componentes, com resultados favoráveis para o reparo de hérnias ventrais complexas (HVC) com ou sem perda de domínio (PD). O objetivo deste estudo é descrever nossa experiência inicial com a separação química dos componentes nos Estados Unidos. Métodos: estudo retrospectivo observacional com todos os pacientes submetidos a reparo de hérnia ventral complexa com ou sem PD entre julho de 2018 e junho de 2020. A TBA pré-operatória foi injetada em todos os pacientes, guiada por ultrassonografia, bilateralmente entre os músculos laterais para alcançar a denervação química antes da operação. Dados demográficos dos pacientes, local da hérnia, dados peri-operatórios e pós-operatórios são descritos. Resultados: 36 pacientes foram submetidos a esta técnica antes do reparo da hérnia. A idade mediana foi 62 anos (30-87). O tamanho mediano pré-operatório do defeito herniário foi 12cm (6-25) e o defeito mediano intra-operatorio foi 13cm (5-27). O volume mediano do saco herniário pré-operatório foi 1.338mL (128-14.040), o volume mediano da cavidade abdominal pré-operatório foi 8.784 (5.197-18.289) mL e a razão dos volumes foi 14%. A duração mediana da operação para aplicação da TBA foi 45 minutos (28-495). O seroma foi a complicação mais comum no pós-operatório, em oito pacientes (22%). O seguimento pós-operatório mediano foi de 43 dias (0-580). Conclusão: a separação pré-operatória de componentes com TBA é tratamento adjuvante seguro e eficaz em reparos de HVC em que aproximação da fáscia é antecipadamente desafiadora.


Subject(s)
Humans , Adult , Aged , Aged, 80 and over , Botulinum Toxins, Type A/therapeutic use , Abdominal Wall/surgery , Neuromuscular Agents/therapeutic use , Preoperative Care , New York , Abdominal Muscles/surgery , Herniorrhaphy , Hernia, Ventral/surgery , Middle Aged
2.
Rev. bras. med. esporte ; 27(2): 201-206, Apr.-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1280061

ABSTRACT

ABSTRACT Introduction: We applied three-dimensional gait analysis to assess the effects of enhanced active contraction of the transversus abdominis (EACTA) during walking. We sought to evaluate the effect of EACTA during walking in order to improve walking quality. Methods: Thirty college students were recruited and trained to perform EACTA during walking. We examined gait parameters under different conditions, including EACTA and habitual ACTA (natural walking with mild contraction of the feedforward mechanism of ACTA, HACTA) during walking using three-dimensional gait analysis. We compared differences in gait parameters under the two walking conditions using SPSS 16.0 statistical software. Results: The following gait parameters were significantly lower under EACTA conditions than under HACTA conditions (P < 0.05): stance phase, 59.151% ± 1.903% vs. 59.825% ± 1.495%; stride time, 1.104 s ± 0.080 s vs. 1.134 s ± 0.073 s:; stance time, 0.656 s ± 0.057 s vs. 0.678 s ± 0.053 s; and swing time, 0.447 s ± 0.028 s vs. 0.454 s ± 0.031 s, respectively. Gait parameters single support phase and mean velocity were significantly higher for EACTA than for HACTA conditions (both P < 0.05). Conclusions: Overall, the results revealed that EACTA during walking can improve gait. This method is simple, and EACTA training during walking to improve gait quality in daily life could provide a positive basis for people to strengthen the transverse abdominal muscle. Level of evidence III; Retrospective comparative study .


RESUMEN Introducción: Aplicamos el análisis tridimensional de la marcha para evaluar los efectos del aumento de la contracción activa del músculo transverso del abdomen (EACTA) durante la caminata. Buscamos evaluar el efecto del EACTA durante la caminata para mejorar su calidad. Métodos: Treinta estudiantes universitarios fueron reclutados y entrenados para realizar el EACTA durante la caminata. Examinamos los parámetros de la marcha en diferentes condiciones, incluyendo EACTA y ACTA habitual (caminata natural con leve contracción del mecanismo de feedforward del ACTA, HACTA) durante la caminata usando análisis tridimensional de la marcha. Comparamos las diferencias en los parámetros de la marcha en las dos condiciones de caminata en el software estadístico SPSS 16.0. Resultados: Los siguientes parámetros de marcha fueron significativamente más bajos en la condición EACTA que en condiciones HACTA (P <0,05): fase de apoyo 59,151 ± 1,903% vs 59,825 ± 1,495%, tiempo de zancada 1,104 s ± 0,080 s vs 1,134 s ± 0,073 s, tiempo de apoyo 0,656 s ± 0,057 s vs 0,678 s ± 0,053 s y tiempo de balance 0,447 s ± 0,028 s vs 0,454 s ± 0,031 s, respectivamente. Los parámetros de la marcha, fase de apoyo simple y velocidad promedio fueron significativamente mayores en el EACTA que en las condiciones HACTA (ambos P <0,05). Conclusiones: En general, los resultados revelaron que el EACTA durante la caminata puede mejorar la marcha. Este método es simple, y el entrenamiento del EACTA durante la caminata para mejorar la calidad de la marcha en la vida diaria puede ser una base positiva para el fortalecimiento del músculo transverso del abdomen. Nivel de evidencia III; Estudio retrospectivo comparativo .


RESUMO Introdução: Aplicamos a análise tridimensional da marcha para avaliar os efeitos do aumento da contração ativa do músculo transverso do abdome (EACTA) durante a caminhada. Procuramos avaliar o efeito do EACTA durante a caminhada para melhorar sua qualidade. Métodos: Trinta estudantes universitários foram recrutados e treinados para realizar o EACTA durante a caminhada. Examinamos os parâmetros da marcha em diferentes condições, incluindo EACTA e ACTA habitual (caminhada natural com leve contração do mecanismo de feedforward do ACTA, HACTA) durante a caminhada usando análise tridimensional da marcha. Comparamos as diferenças nos parâmetros da marcha nas duas condições de caminhada no software estatístico SPSS 16.0. Resultados: Os seguintes parâmetros da marcha foram significativamente mais baixos na condição EACTA do que em condições HACTA (P < 0,05): fase de apoio 59,151 ± 1,903% vs. 59,825 ± 1,495%, tempo de passada 1,104 s ± 0,080 s vs. 1,134 s ± 0,073 s, tempo de apoio 0,656 s ± 0,057 s vs. 0,678 s ± 0,053 s e tempo de balanço 0,447 s ± 0,028 s vs. 0,454 s ± 0,031 s, respectivamente. Os parâmetros da marcha fase de apoio simples e velocidade média foram significativamente maiores no EACTA do que nas condições HACTA (ambos P < 0,05). Conclusões: No geral, os resultados revelaram que o EACTA durante a caminhada pode melhorar a marcha. Esse método é simples, e o treinamento do EACTA durante a caminhada para melhorar a qualidade da marcha na vida diária pode ser uma base positiva para o fortalecimento do músculo transverso do abdome. Nível de evidência III; Estudo retrospectivo comparativo .


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Abdominal Muscles/physiology , Gait , Muscle Contraction/physiology , Imaging, Three-Dimensional , Gait Analysis
3.
Rev. bras. ciênc. vet ; 28(2): 86-91, abr./jun. 2021. il.
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1367378

ABSTRACT

O conhecimento da localização dos órgãos nas diferentes regiões do corpo do animal é essencial para a prática clínica, cirúrgica e para o diagnóstico por imagem. O objetivo do estudo foi descrever a anatomia topográfica abdominal do Didelphisalbiventris. Foram utilizados quatro cadáveres (animais jovens), dois destes destinados para o estudo macroscópico em peças a fresco e os outros fixados em solução aquosa de formaldeído a 10%. Os cadáveres foram dissecados e as estruturas anatômicas identificadas, analisadas e fotografadas. A maioria dos órgãos localizados na região abdominal dos cadáveres da espécie D. albiventris apresentou posição similar aos dos caninos, porém, alguns órgãos e a localização de determinadas estruturas apresentaram particularidades importantes, como a presença dos ossos epipúbicos, a ausência do lobo hepático quadrado, a presença de um ceco desenvolvido e o cólon dividido em três segmentos.


The knowledge about localization of organs in different regions of the animal's body is essential for clinical, surgical and diagnostic imaging practice. The purpose of this study was to describe the abdominal topographic anatomy of Didelphis albiventris. Was used four dead bodys (young animals), two of these was intended for the macroscopic study of fresh pieces and the others fixed in 10% aqueous formaldehyde solution. The corpses was dissected and the anatomic structures was identified, analyzed and photographed. Most of the organs located in the abdominal region of cadavers from species D. albiventris presented structure and position similar to canines, however some of these organs and localization of structures presented important particularities, like the presence of epipubic bones, absence of square hepatic lobe, presence of an developed cecum and colon divided into three segments.


Subject(s)
Animals , Opossums/anatomy & histology , Anatomy, Veterinary , Abdominal Muscles/anatomy & histology , Abdomen/anatomy & histology
4.
Arq. ciências saúde UNIPAR ; 25(1): 31-36, jan-abr. 2021.
Article in Portuguese | LILACS | ID: biblio-1151403

ABSTRACT

A aptidão física se relaciona com marcadores de saúde na infância. O objetivo do presente estudo é mensurar os níveis de aptidão física de escolares, de 10 anos, de acordo com as classificações da base de dados do Projeto Esporte Brasil, 2016 e comparar os resultados das avaliações entre os escolares da rede pública e privada. Participaram desse estudo cento e vinte e seis escolares das cidades de Leme e Pirassununga. Foram determinados o Índice de Massa Corporal e Razão Cintura-Estatura dos indivíduos, que também foram avaliados quanto à aptidão cardiorrespiratória, flexibilidade, resistência muscular abdominal, potência de membros superiores, potência de membros inferiores, agilidade e velocidade. Concluímos que os estudantes da rede pública de ensino apresentaram nível de aptidão física superior em detrimento aos estudantes da rede particular e que os estudantes do sexo masculino da rede privada obtiveram resultados considerados abaixo dos níveis saudáveis para a faixa etária.


Physical fitness is related to health markers in childhood. The aim of this study is to measure the physical fitness levels of 10-year-old schoolchildren according to the classifications in the 2016 Projeto Esporte Brasil database and to compare the results among public and private schoolchildren. One hundred and twenty-six schoolchildren from the cities of Leme and Pirassununga took part in this study. The Body Mass Index and Waist-to-Height Ratio of the individuals were determined. The children were also evaluated for cardiorespiratory fitness, flexibility, abdominal muscle resistance, upper limb power, lower limb power, agility, and speed. It could be concluded that students from the public school system presented a higher level of physical fitness when compared to those from the private system, and that male students from the private school system presented results which were considered below the healthy levels for that age group.


Subject(s)
Humans , Male , Female , Child , Schools , Students , Physical Fitness , Physical Education and Training , Body Height , Body Mass Index , Child Health , Range of Motion, Articular , Abdominal Muscles , Waist Circumference , Pediatric Obesity , Cardiorespiratory Fitness
5.
Article in Chinese | WPRIM | ID: wpr-877642

ABSTRACT

OBJECTIVE@#To observe the effect of abdominal penetrating moxibustion on strength and endurance of core muscle group in patients with stroke.@*METHODS@#Sixty-two patients with stroke were randomly divided into an observation group (31 cases, 2 cases dropped off) and a control group (31 cases, 2 cases dropped off). The patients in the control group were treated with routine basic treatment, acupuncture treatment and rehabilitation training; based on the treatment of the control group, the patients in the observation group were treated with abdominal penetrating moxibustion, approximately 50 min each time, once a day. The treatments in the two groups were given 5 times a week for 4 weeks. The root mean square (RMS) and median frequency (MF) of bilateral transverse abdominis and multifidus of performing sitting-standing and making steps were measured by surface electromyography before and after treatment. The postural assessment scale for stroke (PASS), Berg balance scale (BBS) and lower-limb Fugl-Meyer motor assessment (FMA) scores were observed before treatment, 2 weeks into treatment and 4 weeks into treatment.@*RESULTS@#Compared before treatment, when performing different postures, the RMS and MF of bilateral transversus abdominis and multifidus in the two groups were increased after treatment (@*CONCLUSION@#The abdominal penetrating moxibustion could effectively improve the strength and endurance of core muscle group, improve the posture control, balance ability and lower-limb motor function in patients with stroke.


Subject(s)
Abdominal Muscles , Acupuncture Therapy , Electromyography , Humans , Moxibustion , Stroke/therapy , Stroke Rehabilitation , Treatment Outcome
6.
Clinics ; 76: e2170, 2021. graf
Article in English | LILACS | ID: biblio-1153959

ABSTRACT

The practice of regional anesthesia is in a state of progressive evolution, mainly due to the advent of ultrasound as an anesthesiologist's instrument. Alternative techniques for postoperative analgesia of abdominal surgeries, such as transversus abdominis plane block, oblique subcostal transversus abdominis plane block, rectus abdominis muscle sheath block, ilioinguinal and iliohypogastric nerve block, and quadratus lumborum plane block, have proven useful, with good analgesic efficacy, especially when neuroaxial techniques (spinal anesthesia or epidural anesthesia) are not possible. This review discusses such blockades in detail, including the anatomical principles, indications, techniques, and potential complications.


Subject(s)
Humans , Abdominal Wall/surgery , Abdominal Wall/diagnostic imaging , Nerve Block , Pain, Postoperative , Abdominal Muscles/diagnostic imaging , Ultrasonography, Interventional
7.
Fisioter. Bras ; 21(3): 289-298, Ago 31, 2020.
Article in Portuguese | LILACS | ID: biblio-1283103

ABSTRACT

Diversos processos fisiológicos, bem como alterações viscerais e osteomioarticulares, ocorrem durante a gestação e o parto e impactam de forma significativa o organismo feminino. A expansão do útero afeta a forma do abdome e a geometria dos músculos abdominais, os pesos do útero gravídico aumentam a pressão sobre a musculatura do assoalho pélvico com repercussões estéticas e funcionais. Objetivo: Revisar sistematicamente os estudos publicados nos últimos 10 anos a respeito das técnicas de reabilitação abdominal no pós-parto. Métodos: Foi realizada uma revisão sistemática da literatura, no período compreendido entre os anos de 2009 e 2019, nas bases de dados eletrônicas PubMed, BVS, Science Direct, PEDro. Resultados: Houve uma grande variabilidade em relação às intervenções utilizadas e aos desfechos analisados, sendo verificado estudos sobre flacidez abdominal, fibro edema gelóide, incontinência urinária persistente e tratamento para diástase do reto abdominal (DRA). Conclusão: De acordo com os resultados obtidos no presente estudo e baseados em estudos anteriores, conclui-se que os exercícios abdominais não apresentam mudança significativa para tratamento de IU; são necessários mais estudos para analisar quais tipos de exercícios são eficazes para tratamento de DRA; o aparelho que combina radiofrequência, infravermelho, massagem mecânica e endermologia tem influência positiva no tratamento de flacidez abdominal, fibro edema gelóide e lipodistrofia localizada. (AU)


Several physiological processes, visceral and osteomioarticular, occur during pregnancy and labor and impact significantly the female organism. The uterus expansion affects the abdomen shape and the abdominal muscles geometry, the pregnant uterus weight rises the pressure over the pelvic floor muscles with esthetic and functional repercussions. Objective: To review systematically studies published in the last 10 years about the techniques of abdominal rehabilitation on post childbirth. Methods: Systematic review of literature in the period between 2009 and 2019, on electronic data bases PubMed, BVS, Science Direct, PEDro. Results: There was a great variability in relation to the interventions used and the analyzed outcomes, being checked studies about abdominal flaccidity, fibrosis geloid edema, persistent urinary incontinence (UI) and abdominal rectus diastasis (ARD). Conclusion: According to the results obtained in the present study and based in previous studies, we conclude that abdominal exercises do not show significant change to UI treatment; more studies are necessary to analyze which exercises are effective to ARD treatment and if the machine that combines radiofrequency, infrared, mechanical massage and endermologie has positive influence on treatment for abdominal flaccidity, fibrosis geloid edema and localized lipodystrophy. (AU)


Subject(s)
Humans , Female , Rehabilitation , Abdominal Muscles , Postpartum Period , Physical Therapy Modalities
8.
Rev. bras. anestesiol ; 70(4): 443-447, July-Aug. 2020. graf
Article in English, Portuguese | LILACS | ID: biblio-1137201

ABSTRACT

Abstract Background: There are various approaches to perform an ultrasound guided Quadratus Lumborum Block (QLB). The lateral, posterior, anterior or trans muscular and subcostal paramedian are the various approaches described for performing a QLB. Each of these blocks are aimed to achieve a maximum spread with high volume and low concentration of local anesthetics. Case report: In this novel approach a curvilinear ultrasound probe was used with the patient lying in supine position. The probe was placed longitudinally in the mid axillary line to visualize Quadratus Lumborum Muscle (QLM) in the coronal plane. The needle was then introduced from cranial to caudal direction and catheters were inserted in the Anterior Thoracolumbar Fascia (ATLF) up to a distance of 4-5 cm in 24 patients for an anterior approach to acetabulum fractures. The needle tip and the Local Anesthetic (LA) spread was visible in all patients. All patients except 4 had excellent perioperative pain relief considering stable hemodynamics and VAS 2-3/10 for the first 48 hours. All patients received 1 g intravenous paracetamol each 8 hours. VAS in postoperative period was 2-3/10, in 20/24 patients. In the postoperative period, 4 patients complained of persistent pain, requiring intravenous fentanyl boluses and multimodal analgesia. Mean VAS score was 2.87 from 0-12 hours, 3.14 from 12-24 hours and 3.35 from 24-48 hours. There were no block-related complications in any patient. Conclusion: The supine midaxillary coronal approach to anterior QLB is an effective and feasible approach to QLB which can be performed in supine position.


Resumo Justificativa: Existem várias abordagens para a realização do Bloqueio do Quadrado Lombar (BQL) guiado por ultrassom. Diversas abordagens são descritas para a realização do BQL: paramediana lateral, posterior, anterior ou transmuscular e subcostal, todas com o objetivo de obter a máxima dispersão da solução injetada, usando-se alto volume e baixa concentração de anestésico local. Relato de caso: Nesta nova abordagem, a sonda de ultrassom curvilínea foi usada com o paciente em decúbito dorsal. A sonda foi posicionada longitudinalmente na linha axilar média para visualizar o Músculo Quadrado Lombar (MQL) no plano coronal. A agulha foi introduzida na direção cranial-caudal, e foram inseridos cateteres na Fáscia Toracolombar Anterior (FTLA) até uma distância de 4-5 cm, em 24 pacientes a serem submetidos à correção de fratura do acetábulo pela via anterior. O bisel da agulha e a dispersão do Anestésico Local (AL) eram visíveis em todos os pacientes. Os 24 pacientes, com exceção de quatro, apresentaram excelente analgesia perioperatória, baseando-se na estabilidade hemodinâmica e nos escores EVA de 2-3/10 nas primeiras 48 horas. Todos os pacientes receberam 1 g de paracetamol intravenoso a cada 8 horas. O escore EVA no período pós-operatório foi de 2-3/10, em 20 dos 24 pacientes. No período pós-operatório, quatro pacientes apresentaram queixa de dor persistente, necessitando de bolus de fentanil por via intravenosa e analgesia multimodal. O escore médio da EVA no pós-operatório foi 2,87 entre 0-12 horas; 3,14 entre 12-24 horas e 3,35 entre 24-48 horas pós-operatórias. Não houve complicações relacionadas ao bloqueio em nenhum paciente. Conclusão: A abordagem supina axilar média coronal para BQL anterior é eficaz e viável para BQL, e pode ser realizada com os pacientes em decúbito dorsal.


Subject(s)
Humans , Male , Female , Pain, Postoperative/prevention & control , Anesthetics, Local/administration & dosage , Nerve Block/methods , Time Factors , Supine Position , Abdominal Muscles , Ultrasonography, Interventional , Acetabulum/surgery , Acetabulum/injuries , Acetaminophen/administration & dosage , Middle Aged , Nerve Block/adverse effects
9.
Rev. bras. cir. cardiovasc ; 35(1): 41-49, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1092471

ABSTRACT

Abstract Objective: To compare physical therapy strategies involving abdominal muscle stabilization, with and without upper limb movement, in patients with sternal instability after heart surgery and during in-hospital care. Methods: This prospective, longitudinal, randomized, and comparative clinical study included 20 patients, which were divided into two groups: ARM, the arm group (n=10), and LEG, the leg group (n=10). The study involved the evaluation of scores of visual analog scales for sternal instability, pain, discomfort, functional impairment, lung function, and maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) before and after the interventions. Two protocols consisting of abdominal exercises in both groups with upper limb movements (ARM) and just abdominal activation with leg movements (LEG) were used for three weeks. Results: There were statistically significant (P≤0.01) improvements in pain, discomfort, and functional impairment scores, and in MIP (P=0.04) and MEP (P≤0.01) after intervention in both groups and just LEG showed improvement in forced vital capacity (P=0.043) and forced expiratory volume in one second (P=0.011). Conclusion: Both strategies promoted improvement in pain, discomfort, and functional impairment scores and in the values of inspiratory and expiratory pressures. Perhaps they were influenced by the time and resolution of the infection process, although exercises with upper limb movements seem to be safe in this population. The activation of the infra-abdominal muscles through leg movements seems to bring more benefits to lung function.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Sternum , Cardiac Surgical Procedures , Respiratory Muscles , Prospective Studies , Abdominal Muscles , Lung
11.
Article in English | WPRIM | ID: wpr-811194

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the prognostic value of skeletal muscle depletion measured on computed tomography (CT) in patients with non-metastatic invasive breast cancer.METHODS: This retrospective study included 577 consecutive women (mean age ± standard deviation: 48.9 ± 10.2 years with breast cancer who underwent a preoperative positron-emission tomography (PET)/CT scan and curative surgery between January 2012 and August 2014. The total abdominal muscle area (TAMA), subcutaneous fat area (SFA), and visceral fat area (VFA) were measured on CT images at the L3 vertebral level. Univariate and multivariate Cox proportional-hazard regression analyses were performed to evaluate whether there was an association between sarcopenia and overall survival (OS) outcome.RESULTS: Of the 577 women, 49 (8.5%) died after a mean of 46 months. The best TAMA threshold for predicting OS was 83.7 cm². The multivariate Cox proportional-hazard analysis revealed that sarcopenia (TAMA ≤ 83.70 cm²) was a strong prognostic biomarker (hazard ratio [HR], 1.951; 95% confidence interval [CI], 1.061–3.586), along with large tumor size, axillary lymph node metastasis, high nuclear grade, estrogen receptor status, and adjuvant radiation therapy. In the subgroup analysis of patients aged ≥ 50 years, TAMA (≤ 77.14 cm²) was a significant independent factor (HR, 2.856; 95% CI, 1.218–6.695).CONCLUSION: Skeletal muscle depletion measured on CT was associated with worse OS outcome in patients with non-metastatic breast cancer.


Subject(s)
Abdominal Muscles , Breast Neoplasms , Breast , Estrogens , Female , Humans , Intra-Abdominal Fat , Lymph Nodes , Muscle, Skeletal , Neoplasm Metastasis , Positron-Emission Tomography , Retrospective Studies , Sarcopenia , Subcutaneous Fat
12.
ABCD arq. bras. cir. dig ; 33(1): e1487, 2020. tab, graf
Article in English | LILACS | ID: biblio-1130500

ABSTRACT

ABSTRACT Background: Restoring the contractile function to the abdominal wall is a major goal in hernia repair. However, the core understanding is required when choosing the method for outcome assessment. Aim: To assess the role of the anterolateral abdominal muscles on abdominal wall function in patients undergoing hernia repair by analysis of correlation between the surface electromyography activation signal of these muscles and torque produced during validated strength tests. Methods: Activation of the rectus abdominis, external oblique, and internal oblique/transverse abdominis muscles was evaluated by surface electromyography during two validated tests: Step: 1-A, isometric contraction in dorsal decubitus; 1-B, isometric contraction in lateral decubitus; 2-A, isokinetic Biodex testing; and 2-B, isometric Biodex testing. Results: Twenty healthy volunteers were evaluated. The linear correlation coefficient between root mean square/peak data obtained from surface electromyography signal analysis for each muscle and the peak torque variable was always <0.2 and statistically non-significant (p<0.05). The agonist/antagonist ratio showed a positive, significant, weak-to-moderate correlation in the external oblique (Peak, p=0.027; root mean square, 0.564). Surface electromyography results correlated positively among different abdominal contraction protocols, as well as with a daily physical activity questionnaire. Conclusions: There was no correlation between surface electromyography examination of the anterolateral abdominal wall muscles and torque measured by a validated instrument, except in a variable that does not directly represent torque generation.


RESUMO Racional: A devolução da funcionalidade contrátil da parede abdominal é uma das metas no reparo das hérnias abdominais. Contudo, o entendimento do core deve necessariamente fazer parte na escolha do método de avaliação desse desfecho. Objetivo: Avaliar o papel dos músculos da parede anterolateral na função da parede abdominal com base na correlação entre o sinal de ativação muscular obtido na eletromiografia de superfície e torque produzido durante testes de força validados. Métodos: A ativação dos músculos reto abdominal, oblíquo externo, e oblíquo interno e transverso foi avaliada por eletromiografia de superfície durante dois testes validados. Etapa: 1-A, contração isométrica em decúbito dorsal; 1-B, contração isométrica em decúbito lateral; 2-A, teste isocinético no Biodex; e 2-B, teste isométrico no Biodex. Resultados: Foram avaliados 20 voluntários saudáveis. O coeficiente de correlação linear entre os dados de valor quadrático médio/Pico obtidos análise do sinal da eletromiografia de superfície para cada músculo e o Pico de torque foram sempre <0,2 e estatisticamente insignificantes (p<0.05). A relação agonista/antagonista demonstrou correlação positiva, significativa e de fraca a moderada no músculo externo oblíquo (Pico, p=0,027; valor quadrático médio, 0,564). Os resultados eletromiografia de superfície estiveram positivamente correlacionados nos diferentes protocolos de contração abdominal e também com um questionário de atividade física diária. Conclusões: Não houve correlação entre o exame de eletromiografia de superfície e o torque mensurado por um instrumento validado, exceto em uma variável que não representa diretamente a geração de torque.


Subject(s)
Humans , Abdominal Wall , Abdominal Muscles , Torque , Electromyography , Isometric Contraction
13.
Clinics ; 75: e1623, 2020. tab, graf
Article in English | LILACS | ID: biblio-1133402

ABSTRACT

OBJECTIVES: To verify the pyramidalis muscle's frequency (bilaterality, unilaterality, or absence) and morphometry (length of the medial border and width of its origin/base) in a sample of the Brazilian population and the anthropometric influence. METHODS: Dissection of 30 cadavers, up to 24h post-mortem. RESULTS: The pyramidalis muscle was present bilaterally and unilaterally in 83.33% and 3.33% of the cadavers, respectively, and absent in 13.33%. The muscles on the right and left sides were symmetrical in length but not in width; the pyramidalis muscles of men were longer, while those of the women were wider. We also found that there was greater variation in the dimensions (length and width) of the men's muscles. Finally, in this sample of the Brazilian population, the pyramidalis muscle's unilaterality was more prevalent than in other populations, and its complete absence was less prevalent. CONCLUSIONS: There were no cases of muscle duplication in one or both sides, as described in some studies. Despite all of its morphometric variation, the pyramidalis muscle maintained its triangular shape with longitudinal fibers in every case. Furthermore, no statistically significant correlation was noted between the muscles' dimensions and person's age, height, weight, or gender.


Subject(s)
Humans , Male , Female , Adult , Abdominal Muscles , Brazil , Cadaver
14.
Fisioter. Mov. (Online) ; 33: e003337, 2020. tab
Article in English | LILACS | ID: biblio-1133910

ABSTRACT

Abstract Introduction: The voice is heavily influenced by breathing and abdominal muscles. Objective: To verify the immediate effects of cervical stimulation and diaphragmatic release on the respiratory and phonatory function of adult women with no vocal complaints. Method: Relaxation maneuvers and eccentric work of the diaphragm were performed together with articulatory maneuver of the third cervical vertebra. Twenty-four women without vocal complaints, aged between 18 and 35 years were part of the intervention. All volunteers were submitted to an evaluation of respiratory muscle strength, maximum phonation time of the vowel /a/, sound pressure level and acoustic vocal analysis, before and after physiotherapeutic intervention. Statistical analysis consisted of the Student's t-test for independent samples and Spearman's correlation. Significance level was set at 5%. Results: There was a significant increase in the maximum phonation time of the vowel /a/ and in the modal sound pressure level. Regarding the acoustic analysis, there was a reduction in the standard deviation values of the fundamental frequency; in the smoothed pitch disturbance quotient; and in the fundamental frequency and amplitude variations. Conclusion: Cervical stimulation and diaphragmatic release improved vocal quality regarding duration of emission, sound pressure, and stability and noise of the glottic signal.


Resumo Introdução: A voz é muito influenciada pela respiração e pela musculatura abdominal. Objetivo: Verificar os efeitos imediatos da estimulação cervical e liberação diafragmática na função respiratória e fonatória de mulheres adultas sem queixas vocais. Método: Realizaram-se manobras de relaxamento e trabalho excêntrico do diafragma junto a uma manobra articulatória da terceira vertebra cervical. Fizerem parte da intervenção 24 mulheres sem queixas vocais, com idades entre 18 e 35 anos. Todas as voluntárias foram submetidas a uma avaliação de força da musculatura respiratória, do tempo máximo de fonação da vogal /a/, do nível de pressão sonora e análise vocal acústica, pré e pós-intervenção fisioterapêutica. Foram realizados os testes t-student para amostras independentes e correlação de Spearman com nível de significância de 5%. Resultados: Verificou-se aumento significativo no tempo máximo de fonação da vogal de /a/ e do nível de pressão sonora modal. Na análise acústica, houve redução dos valores do desvio-padrão da frequência fundamental; do quociente de perturbação do pitch suavizado; da variação da frequência fundamental e da variação da amplitude. Conclusão: As manobras fisioterapêuticas de estimulação cervical e liberação diafragmática melhoraram a qualidade vocal em relação ao tempo de sustentação da emissão, à pressão sonora, à estabilidade e ao ruído do sinal glótico.


Subject(s)
Humans , Female , Adolescent , Adult , Voice Quality , Acoustics , Diaphragm , Respiration , Abdominal Muscles
15.
Rev. bras. anestesiol ; 69(2): 208-210, Mar.-Apr. 2019. graf
Article in English | LILACS | ID: biblio-1003402

ABSTRACT

Abstract Introduction: Hip surgery is a major surgery that causes severe postoperative pain. Although pain during rest is usually considerably reduced mobilization is important in terms of thromboembolic complications. The quadratus lumborum block is a regional analgesic technique that blocks T6-L3 nerve branches. This block may provide adequate analgesia and reduce opioid consumption after hip surgery. Case report: We performed continuous quadratus lumborum type 3 block in two patients who underwent hip arthroplasty. Postoperative 24-h pain scores, local anesthetic consumptions on patient-controlled analgesia and additional analgesic requirement were recorded. In two patients, postoperative pain scores were less than 6 during rest and physiotherapy. Patient was mobilized in the early postoperative period without additional opioid analgesic requirement and without muscle weakness. Discussion: Continuous quadratus lumborum block may be used to relieve postoperative acute pain in hip surgery because it provides one-sided anesthesia without muscle weakness.


Resumo Introdução: A cirurgia de quadril é uma cirurgia de grande porte que causa dor intensa no pós-operatório. Embora a dor durante o repouso seja consideravelmente reduzida, a mobilização é importante em termos de complicações tromboembólicas. O bloqueio doquadrado lombar é uma técnica analgésica regional que bloqueia os ramos nervosos de T6-L3. Esse bloqueio pode fornecer analgesia adequada e reduzir o consumo de opioides após cirurgiasde quadril. Relato de caso: Realizamos o bloqueio contínuo do quadrado lombar tipo 3 em dois pacientes submetidos à artroplastia de quadril. Durante as 24 hs de pós-operatório foram registrados os escores de dor, o consumo de anestésicos locais em analgesia controlada pelo paciente e a necessidade de analgésicos adicionais. Em dois pacientes, os escores de dor pós-operatória foram < 6 durante o repouso e fisioterapia. O paciente foi mobilizado no período pós-operatório imediato, sem precisar de analgésico opioide adicional e sem fraqueza muscular. Discussão: O bloqueio contínuo do quadrado lombar pode ser usado para aliviar a dor aguda no pós-operatório de cirurgia de quadril porque fornece anestesia unilateral sem fraqueza muscular.


Subject(s)
Humans , Male , Female , Aged , Pain, Postoperative/prevention & control , Arthroplasty, Replacement, Hip/methods , Anesthetics, Local/administration & dosage , Nerve Block/methods , Pain Measurement , Analgesia, Patient-Controlled/methods , Abdominal Muscles
16.
Rev. bras. cir. plást ; 34(1): 23-40, jan.-mar. 2019. ilus, tab, graf
Article in Portuguese | LILACS | ID: biblio-994538

ABSTRACT

Introdução: A necessidade de oferecer resultados com maior definição nas abdominoplastias nos compele a evoluir tecnicamente. O objetivo deste trabalho é apresentar a técnica de plicatura em Crossbow com suas três variantes, reforçando o conceito de aproximação vertical e horizontal da aponeurose dos músculos retos e oblíquos abdominais ao mesmo tempo, promovendo dois vetores diferentes de tração, culminando em uma maior definição da parede abdominal, principalmente na região do hipogastro e fossas ilíacas. Métodos: No período entre janeiro de 2016 e fevereiro de 2018, foram realizadas 22 cirurgias exclusivamente com a técnica Crossbow em seus tipos l, ll e lll, tanto em pacientes estéticos como pós-bariátricos. Resultados: Os resultados foram favoráveis tanto do ponto de vista estético, com maior definição do hipogastro, como do ponto de vista clínico, uma vez que nenhum paciente apresentou sinais ou sintomas diferentes de técnicas convencionais. Conclusão: A técnica Crossbow é simples e reprodutível, sendo mais um agregante na armamentária para melhorar a estética abdominal. Apesar de promover o reforço da região hipogástrica, tanto para tratamento primário como secundário desta região, só o aumento da casuística poderá demonstrar as possíveis vantagens do método.


Introduction: Owing to the need to deliver results with greater definition in abdominoplasties, techniques must evolve. The objective of this study was to introduce the crossbow technique for plication along with its three variants that reinforces the concept of vertical and horizontal alignments of the aponeurosis of the rectus and oblique abdominis muscles at the same time, promotes 2 different traction vectors, and culminates in a greater definition of the abdominal wall, mainly in the hypogastrium and iliac fossa regions. Methods: From January 2016 to February 2018, 22 surgeries were performed exclusively with the types l, ll, or lll crossbow technique, both in esthetic surgery cases and post-bariatric patients. Results: The results were favorable both from the esthetic point of view, with greater definition of the hypogastrium, and from a clinical point of view, as none of the patients showed signs or symptoms different from those of the conventional techniques. Conclusion: The crossbow technique is a simple and reproducible tool in the medical armamentarium to improve abdominal esthetics. Although it promotes the strengthening of the hypogastric region, both for primary and secondary treatments of this region, only a sample size increase can demonstrate the possible advantages of the method.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Postoperative Complications/prevention & control , Abdominal Muscles/surgery , Reconstructive Surgical Procedures/adverse effects , Reconstructive Surgical Procedures/methods , Abdominal Wall/abnormalities , Abdominal Wall/surgery , Aponeurosis/abnormalities , Aponeurosis/surgery
17.
Article in Korean | WPRIM | ID: wpr-765442

ABSTRACT

PURPOSE: This study examined the effects of plank exercise combined with breathing and arm exercises on the external oblique, internal oblique, and transverse abdominal muscle thickness. METHODS: Thirty healthy adults consisting of 12 males and 18 females from K area were divided into a plank exercise combined with breathing and arm exercises group (n = 15) and a plank exercise only group (n=15). The changes in muscle thickness before the exercise and four and eight weeks after the exercise were analyzed using a two-way repeated analysis of variance (ANOVA). The significance level was set to α=0.05. Post-hoc t-tests were conducted to detect the interactions between the time and groups, and the significance level was set to α=0.01. RESULTS: According to the experimental results, the external oblique abdominal muscle showed significant differences over time (p<0.05). The internal oblique abdominal muscle also showed significant differences over time and in the interactions between the time and groups (p<0.05). The transverse abdominal muscle showed significant differences over time, in the interactions between time and groups, and in the changes between the groups (p<0.05). CONCLUSION: The results indicated that plank exercise combined with breathing and arm movement exercises led to increases in the abdominal muscle thickness. These types of exercises may be useful in lumbar stabilization rehabilitation treatment.


Subject(s)
Abdominal Muscles , Adult , Arm , Exercise , Female , Humans , Male , Rehabilitation , Respiration
18.
Article in English | WPRIM | ID: wpr-765433

ABSTRACT

PURPOSE: To improve pulmonary function and decrease in balance ability with increasing forward head position and vertebral curvature, we applied Figure-8 brace to confirm the immediate effect on vital capacity and balance and to see if it is applicable. METHODS: A total of 34 elderly women aged 65 or older and young women in their 20s with FHP were screened to measure vital capacity, measuring the forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), and measuring the foot pressure to see the change in balance. For statistical analysis, the difference between pre and post values was compared using pared t-test. RESULTS: As a result of vital capacity measurements, there was no significant difference between FEV1 and FVC for women over 65 years old (p>0.05). Young women in their 20s had no significant difference in FEV1 (p>0.05), and FVC had significant differences (p<0.05). In measuring foot pressure to measure balance, both women aged 65 and above and young women in their 20s had a significant decrease in anterior foot pressure, and a significant increase in posterior foot pressure (p<0.05). CONCLUSION: The results of this study did not positively affect the vital capacity of elderly women with FHP. However, the significant increase in vital capacity of young women in their 20s suggests that contraction of the abdominal muscle is necessary during forced expiration. Therefore, it is believed that proper application and therapeutic interventions should be combined when applying Figure-8 brace.


Subject(s)
Abdominal Muscles , Aged , Braces , Female , Foot , Forced Expiratory Volume , Head , Humans , Posture , Vital Capacity
19.
Article in Korean | WPRIM | ID: wpr-765425

ABSTRACT

PURPOSE: The purpose of this study was to examine the effects of plank exercises with resistance of one-sided hip adduction on abdominal muscle thickness. METHODS: Thirty subjects were divided into a group that underwent plank exercises with one-sided hip adduction resistance (n=15) and a group that underwent plank exercises only (n=15). Their changes in abdominal muscle thickness before the experiment (n=15) and three and six weeks after the experiment were analyzed using a two-way repeated analysis of variance at a statistical significance level of α=0.05. When there was any interaction between the time of measurement and each group, post hoc t-tests were conducted at a statistical significance level of α=0.01. RESULTS: The results of the experiment showed statistically significant differences in the thickness of the rectus abdominis, internal oblique muscle, and transversus abdominis, depending on the time of measurement and the interaction between the time of measurement and each group (p<0.05). Statistically significant differences were observed in the thickness of the external oblique, depending on the time of measurement, the interaction between the time of measurement and each group, and variances between the groups (p<0.05). CONCLUSION: The results of this study indicated that plank exercises with resistance of one-sided adduction are effective for increasing abdominal muscle thickness. The study's overall findings will likely be used as basic data for lumbar stabilization exercises and rehabilitation treatment.


Subject(s)
Abdominal Muscles , Exercise , Hip , Rectus Abdominis , Rehabilitation
20.
Article in Chinese | WPRIM | ID: wpr-772071

ABSTRACT

OBJECTIVE@#To compare the efficacy and safety of postoperative analgesia with low-dose sufentanil combined with transversus abdominis plane (TAP) block and with sufentanil alone in promoting patients'recovery following laparoscopic hysterectomy.@*METHODS@#Sixty patients undergoing laparoscopic hysterectomy in our hospital between September, 2016 and August, 2017 were randomly allocated into two equal groups. In group A, the patients were given postoperative analgesia with 1 μg/kg sufentanil, 9.96 mg tropisetronmesylate, and 200 mg flurbiprofen axetil (diluted with 0.9% NaCl solution to 100 mL, pumped at the rate of 2 mL/h) combined with TAP block; in group B, the patients received similar postoperative analgesia but at a higher dose of sufentanil (2 μg/kg) without TAP block. Visual analogue scale (VAS) was used to evaluate pain at 15 min and at 4, 8, 12, 24 and 48 h postoperatively, and the first off-bed time, the length of postoperative hospital stay and the incidence of postoperative nausea and vomiting (PONV) were recorded in all the patients.@*RESULTS@#Compared with those in group B, the patients in group A had significantly lower VAS scores at 15 min, 4 h, 8 h, and 12 h postoperatively ( < 0.01) with also statistically shorter first off-bed time and postoperative hospital stay ( < 0.01). Two (6.7%) patients in group A had mild PONV, and 6 (20.0%) in group B had PONV (including 4 with mild and 2 with moderate PONV).@*CONCLUSIONS@#Lowdose sufentanil combined with TAP block is effective for postoperative analgesia after laparoscopic hysterectomy and helps to reduce the incidence of PONV and shorten the first off-bed time and postoperative hospital stay to promote the recovery of the patients.


Subject(s)
Abdominal Muscles , Analgesics, Opioid , Female , Humans , Hysterectomy , Laparoscopy , Pain Measurement , Pain, Postoperative , Sufentanil
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